Sex After Illness: 5 Things You Must Know

How to overcome your physical and emotional fears — and resume lovemaking.

Illness has a psychological as well as a physical impact. Once you have faced a life-threatending illness, or one that required a major lifestyle changes, you may feel different about everything. That's natural and normal, but at some point you have to re-embrace life — and that includes being able to relate to yourself, and your partner, sexually.

After a major illness or surgery, take small steps to re-establish intimacy with your partner. — Nordic Photos/Getty Images

That's often hard to do. Sometimes there are consequences of treatment — for example a lot of cancer patients need radiation, chemo and other medications that depress sexual arousal and interest. This is also true for medications for depression, diabetes and heart problems.

Even after the medications are no longer necessary or calibrated so that the effects are much less potent, the disruption of sexual life can become a habit, which creates an emotional chasm that is hard to cross. Still, hard as it is to recapture your sexual feelings and sexual connection, the fact is that sex is an important part of a relationship and letting it disappear for too long can undermine the intimacy and happiness of a marriage or cohabitation. A partner will be understanding for a long time, but not forever. And think about this: something that gave you extreme pleasure once is not something to be given up unless there is no other option. So here are some suggestions about how to get back in the game.

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Face your fears. What is stopping you from getting physical? Whatever it is, you need to attend to it. If there are fears of physical danger after a heart attack, ask your physician about what your real risks are (usually having sex is just fine). If you are upset about body image because of scars or drastic changes in the way you look, don't assume your partner feels differently about you or desires you less. You need to face your fears and work diligently to resolve them.

Communicate the full range of your feelings to whomever you need to talk to. Talk to a counselor if you hit a wall and can't resolve your fears. Talk to your partner about how you are feeling and why you are stymied. Discuss with your partner about how your illness has affected him or her and find out how he or she feels about resuming your sexual life together. Ask for support and validation so that you feel sexy and wanted. Talk to your doctor about your medications, etc.

Get yourself in the mood. If your bed has been somewhere you were confined during your illness, go somewhere else that doesn't have the same connotation. Use a different bedroom, go to a friend's house or go somewhere romantic — walk the beach or go see romantic comedies. Do things that will help you relax and enjoy each other with the idea of creating sensual and sexy feelings.

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Start with baby steps. You don't have to have intercourse right away. Get back into practice with kissing, stroking each other's bodies and slowly increasing arousal. Talk to each other about your concerns, such as not being able to have an erection or orgasm. Back off a bit if you or your partner is feeling stressed. As long as you don't shelve sex indefinitely, give yourself permission to go slow and just make each other feel good

Find out about current sexual medicine. Men facing sexual complications from prostate medications or surgery should not hesitate to ask their doctor or sex therapist about erectile aids such as Viagra, Levitra or Caelis. If women experience pain during intercourse caused by chemotherapy, a hysterectomy or overectomy, or medication-induced lack of lubrication, they should ask a medical professional about suitable lubricants that will help make penetration smooth and comfortable. If there is no issue about cancer, some women should consider whether an estrogen ring is right for them. Many women find vaginally inserted estrogen immediately rehabilitates thinning vaginal tissues and low levels of lubrication.

It may be startling to feel sexually shy or awkward with a partner of many years post surgery or an impactful illness. The stress and insecurity may be even more magnified if you do not have a steady partner and you are just beginning to date again. In this case, you may need even more courage when you tell the person you are dating about your limits, fears or issues. Still, once you do open up, or resume your sexual life, you may be pleasantly surprised how compassionate and loving people can be. I think most men and women over 50 are old enough to know that bodies are vulnerable and that perfect health will not be ours forever. We can accept this inevitability, but we don't have to extinguish our sexuality in the process. With communication, honesty, innovation and knowledge, our sex lives can always remain a satisfying part of our lives and relationships.